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Individual

MR. LANCE ORBIN IDLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
1620 EASTPOINT PKWY, LOUISVILLE, KY 40223-4123
(502) 245-4239
Mailing address
107 SIMPSON STATION DR, SIMPSONVILLE, KY 40067-5410
(502) 314-9038

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11491
KY
183500000X
Pharmacist
12192
OK

Other

Enumeration date
02/27/2007
Last updated
07/17/2009
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